Kangaroo Mother Care

Numerous studies over more than two decades have shown that what is now known as Kangaroo Mother Care (KMC), is best for both full-term and premature babies in every way. When separated from their mothers, babies' vital signs show that they are in distress (breathing, heart rate, temperature, hormones, etc. become irregular), but when reunited with their mothers, babies' vital signs normalise, and they begin to thrive.

Healthy Babies

All "healthy" newborns (including premature babies above 2.5lbs) should be place skin-to-skin on the mother's naked chest and kept there permanently, or as much as is possible, immediately after birth. Pediatric examinations or resuscitation can be done on the mother's chest if needed. Mother and baby can be covered by a warm blanket if the room is cold, and a knitted cap on the baby's head will prevent heat loss through the head.

If medical assistance is needed, it can be given on the mother's chest. Babies can be tube fed, on IV drips and on ventilators while on the mother's chest, and babies' vital signs stabilise better in their natural habitat (skin-to-skin with their mother) than if they are placed in incubators or heated cots. If removed from their mothers, newborns make high levels of cortisol (a stress hormone that can cause brain damage) but when returned to their mother's chest, their hormones normalise.

Breastfeeding should be initiated within the first hour of life if the baby is mature enough to be able to suck, and should continue on cue nursing from then on. In the case of undrugged, full term babies, it is best to place them on their mother's chest, with the baby's head between her breasts. Using his sense of smell and the grasp reflex (along with "head bobbing") the baby will self-attach to the breast, and is more likely to get the correct latch-on position, than if baby were held and assisted in finding the breast. (Drugged and premature babies may need assistance).

On discharge from the hospital, the mother should be encouraged to wear her baby, skin-to-skin in a kangaroo carrier, or other carrier where the mother wraps her baby on her chest, throughout the day. At night the baby should sleep within an arm's reach of his mother, either on a safe bed sleeping surface, or in a side-crib attached to the mother's bed. Mom should be able to touch her baby at all times, and baby's vitals will be regulated by being close to his mother. In this environment, a baby is also reassured by the sound of his mother's breathing, heartbeat, touch and smell. Breastfeeding should continue on cue.

Ill Babies

In the case of very tiny, or ill babies, they may need incubator care, but if this is necessary, the mother should be encouraged to be with her baby as much as possible, with her hand in the incubator, touching her baby, reassuring her baby of her presence. Through touch and the sound of her voice, a baby's stress hormones decrease and vitals regulate. If the mother is ill as well and unable to be with her baby, her baby should be wrapped skin-to-skin on the father's chest. If the baby is in an incubator, the father should be with the baby, touching and talking to the baby as much as possible. The baby will recognise his father's voice, and be reassured by his presence. Babies tube fed in the NICU should receive their mother's pumped milk, or the milk of another mother. And exclusive diet of human milk benefits premature babies, and the sicker a newborn is, the more desperately he needs this healing gold.

In the case of very ill babies, they should still be held skin-to-skin on their mother's chest for as many hours per day as is possible, and the mother can sit in a comfortable reclining chair in the NICU nursery to do so. Normal Kangaroo Mother Care should be instituted as soon as possible. If very tiny premature twins are born needing incubator care, they should be placed together in the same incubator. Twin babies who can feel each other's presence physically survive better than if they are separated.

Babies born with conditions that are incompatible with life, should be kept on their mother's chest so that they are not distressed during their short lives. Having held her dying baby will also help the mother to grieve and let go. Very tiny babies, believed to be dead, should also be placed skin-to-skin on the mother. There are numerous documented cases of these babies "miraculously reviving" from the warmth of their mother's body and the reassuring sound of her heartbeat.

Kangaroo Mother Care is summed up well with this simple lesson: Never separate a mother and her newborn unless it is absolutely unavoidable.

Kangaroo Mother Care Notes

The process of holding a baby on one's chest, skin-to-skin, is referred to as Kangaroo Mother Care. However, it is a practice that all mammals participate in naturally (watch a cat with her new kittens or dog with her newborn puppies). Kangaroo Mother Care benefits all human babies as well, and especially NICU babies, in several ways.

*KMC babies stabilize faster with skin-to-skin care than in an incubator (very few newborns stabilize well within an incubator during the first fragile hours of life).

*KMC babies have stable oxygen rates and breathing thanks to the steady regulation of mother's respiration.

*A baby's temperature is most stable on his mother - in skin-to-skin care mother's chest automatically warms to warm a cold baby, while her core temperature drops if baby is too warm and needs to be cooled.

*Sleeping within an arm's reach of baby (as long as a parent does not smoke) also regulates all of his physiological needs in the same way ~ they are kept steady thanks to Mom's warm, even-paced body. We lose far fewer babies to prematurity, irregularity of breathing or heartbeat after birth, and SIDS all with the natural help of skin-to-skin holding, or Kangaroo Care.

14 comments:

I could not agree more. I had requested in-room triage with my firstborn, so he could be with me for any examinations, etc. He was a healthy, full-term baby, but the nursing staff told me that they were too busy for in-room triage, and he would have to go to the nursery for evaluations. Plus, the nurse told me that the best place for a newborn baby was in the incubator. Well, I hated to be that "high maintenence" new Mom that they probably dread, but none of that was happening. He was perfectly content to be with me, and they just had to deal with it. I lovingly nourished and cared for my son for 9 months to have him put in an incubator upon birth? I don't think so.

I totally agree! Also, I think the whole medical community is coming around on this too.

Our son got skin to skin contact immediately and was with me pretty much the whole time in the hospital. There were a few brief trips to the nursery to get weighed and tested and such, but he was right with me most of the time.

They offered to put him in the nursery so we could sleep, but we didn't take that option and the staff was totally understanding and supportive.

Im very vocal about Kangaroo Care. My son was born two months early and I was allowed to hold him within 24 hrs and the nurses were so vocal about me doing skin to skin and Im glad that the spoke up about it. I have researched the topic ever since and Im so hoping that it catches on is all hospitals for all full-term and pre-term babies. When I have my future children I plan on holding the skin to skin when ever possible.

I know that kangaroo care has grown widely in acceptance, but I still don't understand why skin to skin after a normal birth is not routine, and why especially after doing KC, do people not want to continue after the time in the hospital, by babywearing. It's not a need that is met the day the baby is discharged.I have a signature on my emails that says "Children should be held by people, not things; Why not try a sling?". It used to say "Babies..." but many people think just of newborns.

I'm a mommy to six children, and have loved being a babywearing Mama. Especially for my last two children who were a bit early and needed a NICU stay. I'm sure it made it easier for us to bond. Now I'm expecting a baby with a Neural Tube Defect that will require surgery after birth. You'd better believe I'll be packing my wrap sling! I want him to know every minute that he can, that I'm right there for him.

As a NICU nurse, I <3 skin to skin!! We are super pro-breastfeeding, and I'm so relieved to work in a hospital where it is expected (and well supported) that moms pump. We don't have visiting hours, we have "parenting time", which is 100% access all day, although we ask that parents step out during shift change (for privacy), although exceptions are made on a regular basis for things like skin to skin, breastfeeding, a very sick baby, etc.

We're getting a brand new NICU sometime in the next 5 years that will further foster skin to skin and breastfeeding, and I'm tickled pink by the idea! :) Thanks for all the resources!!

My preemie was born 2#10oz but was 2#3oz when I first held her @ 3 days old (Christmas Day). After just 2 days of holding her skin to skin for and hour or more, on the third day (and each following day) she would become alert and anticipate/look for me to come. It was the only feeding (tube) she would wake for (and she would wake and become excited 5 - 15 min before my 3PM feeding/holding time). Because I bf, we put her on my chest while tube feeding her (and later at the nipple) in order to associate my smell and later my breasts with feeding. @ 20 months, bfing is going strong and saved us from need a abdominal tube for feeding (due to immature swallow) I totally <3 kangaroo care.

I am holding my 35 week preemie on my chest at the moment. We just got out of NICU this week, where I spent most of the time holding him in the recliner, then the staff got a clue and pulled in a bed for the next 2 nights. He is still having feeding issues, but the skin to skin is really helping as we sit basking in the light of a window to help his jaundice. The NICU he was in seems to be in-between. They didn't fight me, but did not actively push either.

I wish that the staff at hospitals would understand how important this is for mothers too. My nicu had signs all over about Kangaroo Care and yet I was separated from my son for over twenty four hours. Was I ill? Yes, with high blood pressure but not so I'll that we should have been separated for that long. This led to a lot of stress, PTSD, and increasing blood pressure for months afterwards. My son was also stable, though needed monitoring. Both moms and babies need the skin-to-skin and the definition of ill needs to be very very narrowly defined. I have also read stories of women who were in the icu after birth, whose babies were brought to them and placed skin-to-skin, who made amazing recoveries.

I am a nurse and skin to skin is absolutely where the baby belongs. The only thing I disagree with is resuscItatIon. You cannot effectively rescusitate on a mothers chest. Other than that the baby should never leave the chest.

My daughter was 13 weeks premature. From the moment I was able to I held her skin to skin every single day. The nurses at the hospital were BIG advocates of kangaroo care! That and breast milk from day one kept her, in my belief, healthy and helped her to strive! She's now almost 9 and we have absolutely NO medical problems what so ever.